Quadroiliac Plane Block Versus Transmuscular Quadratus Lumborum Block for Postoperative Analgesia After Total Hip Arthroplasty

Tanta University40 enrolled

Overview

This study aims to evaluate and compare the postoperative analgesic efficacy, opioid consumption, motor function preservation, and quality of recovery of ultrasound-guided Quadroiliac Plane Block (QIPB) versus transmuscular quadratus lumborum block (QLB) in patients undergoing THA under spinal anesthesia.

Total hip arthroplasty (THA) is a common orthopedic procedure for end-stage hip diseases such as osteoarthritis and avascular necrosis. It is highly effective in relieving pain and restoring function. The quadratus lumborum block (QLB) is one such fascial plane technique. It provides analgesia through spread of local anesthetics within the thoracolumbar fascia. This allows potential involvement of lumbar plexus branches. The Quadroiliac Plane Block (QIPB) is a newer regional technique for hip and pelvic surgery. It targets fascial planes near the iliac region to block sensory innervation of the hip. Early studies suggest it may provide effective postoperative analgesia.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Quadroiliac Plane Block Transmuscular Quadratus Lumborum Block

Interventions

Quadroiliac Plane BlockDRUG

Patients will receive an ultrasound-guided Quadroiliac Plane Block (QIPB) using 20 mL of bupivacaine 0.25%.

Transmuscular quadratus lumborum blockDRUG

Patients will receive ultrasound-guided quadratus lumborum block (QLB) (transmuscular approach) using 20 mL of 0.25% bupivacaine.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age 18-75 years. * Both sexes. * American Society of Anesthesiologists (ASA) classification I-III. * Scheduled for elective primary unilateral total hip arthroplasty under spinal anesthesia. Exclusion Criteria: * Allergy to local anesthetics. * Infection at the injection site. * Coagulopathy or bleeding disorders. * Neuromuscular disorders. * Chronic opioid use or dependence. * Body mass index (BMI) \> 40 kg/m². * Severe cardiac, hepatic, renal, or respiratory dysfunction. * Contraindication to regional anesthesia.

Outcomes

Primary Outcomes

Total morphine consumption

Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4.